Senior Educators: Plan Overview for SecureHorizons by UnitedHealthcare AARP MedicareComplete Essential Medicare Plan

1-800-505-8575

Plan Overview for:

AARP MedicareComplete Essential

SecureHorizons by UnitedHealthcare

Please review the following important information about benefits and coverage for the plan you selected.

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Premium
$0.00
per month

Overview

Doctors	Primary Care	Specialists	See plan doctors only
	$15	$30	per visit in network

Hospitals	Use plan hospitals only
	In-Network For Medicare-covered hospital stays: Days 1 - 8: $125 copay per day Days 9 - 90: $0 copay per day $0 copay for each additional hospital day. No limit to the number of days covered by the plan each benefit period. Except in an emergency, your doctor must tell the plan that you are going to be admitted to the hospital.

Other Important Information

Important notes: The important information in this overview section is intended to provide a quick summary of the information most of our clients request. More complete summary information about the plan is shown below and is accurate as of October 7, 2009 according to Medicare. You can download a copy of the plan's Summary of Benefits here.

Click To Enroll or Call 1-800-505-8575


Resources
	Benefits Summary	Click to Download
	Application Form	Click to Download
Fixed Cost Details
	Premium	$0.00
Important Information
	General Plan Information	Medicare Health Plan For Profit HMO Provides health coverage only Approved by Medicare NYC and Rockland, Orange, and Westchester Counties
1	Premium and Other Important Information	General $0.00 monthly plan premium in addition to your monthly Medicare Part B premium.
2	Doctor and Hospital Choice	In-Network You must go to network doctors, specialists, and hospitals. No referral required for network doctors, specialists, and hospitals. Out-of-Network Plan covers you when you travel in the U.S.
Inpatient Care
3	Inpatient Hospital Care	In-Network For Medicare-covered hospital stays: Days 1 - 8: $125 copay per day Days 9 - 90: $0 copay per day $0 copay for each additional hospital day. No limit to the number of days covered by the plan each benefit period. Except in an emergency, your doctor must tell the plan that you are going to be admitted to the hospital.
4	Inpatient Mental Health Care	In-Network For Medicare-covered hospital stays: Days 1 - 8: $125 copay per day Days 9 - 90: $0 copay per day You get up to 190 days in a Psychiatric Hospital in a lifetime. Except in an emergency, your doctor must tell the plan that you are going to be admitted to the hospital.
5	Skilled Nursing Facility	General Authorization rules may apply. In-Network For Medicare-covered SNF stays: Days 1 - 14: $0 copay per day Days 15 - 40: $110 copay per day Days 41 - 100: $0 copay per day Plan covers up to 100 days each benefit period No prior hospital stay is required.
6	Home Health Care	General Authorization rules may apply. In-Network $0 copay for each Medicare-covered home health visit.
7	Hospice	General You must get care from a Medicare-certified hospice.
Outpatient Care
8	Doctor Office Visits	General See "Physical Exams," for more information. In-Network $15 copay for each primary care doctor visit for Medicare-covered benefits. $30 copay for each in-area, network urgent care Medicare-covered visit. $30 copay for each specialist visit for Medicare-covered benefits.
9	Chiropractic Services	General Authorization rules may apply. In-Network $30 copay for each Medicare-covered visit. Medicare-covered chiropractic visits are for manual manipulation of the spine to correct subluxation (a displacement or misalignment of a joint or body part) if you get it from a chiropractor or other qualified providers.
10	Podiatry Services	In-Network $30 copay for each Medicare-covered visit. $30 copay for up to 6 routine visit(s) every year Medicare-covered podiatry benefits are for medically-necessary foot care.
11	Outpatient Mental Health Care	General Authorization rules may apply. In-Network $40 copay for each Medicare-covered individual or group therapy visit.
12	Outpatient Substance Abuse Care	General Authorization rules may apply. In-Network $40 copay for Medicare-covered individual or group visits.
13	Outpatient Services/Surgery	General Authorization rules may apply. In-Network $190 copay for each Medicare-covered ambulatory surgical center visit. $190 copay for each Medicare-covered outpatient hospital facility visit.
14	Ambulance Services	In-Network $150 copay for Medicare-covered ambulance benefits.
15	Emergency Care	General $50 copay for Medicare-covered emergency room visits. Worldwide coverage. If you are admitted to the hospital within 24-hour(s) for the same condition, you pay $0 for the emergency room visit
16	Urgently Needed Care	General $40 copay for Medicare-covered urgently needed care visits.
17	Outpatient Rehabilitation Services	In-Network $30 copay for Medicare-covered Occupational Therapy visits. $30 copay for Medicare-covered Physical and/or Speech/Language Therapy visits.
Outpatient Medical Services and Supplies
18	Durable Medical Equipment	General Authorization rules may apply. In-Network 20 % of the cost for Medicare-covered items.
19	Prosthetic Devices	General Authorization rules may apply. In-Network 20 % of the cost for Medicare-covered items.
20	Diabetes Self-Monitoring Training, Nutrition Therapy, and Supplies	In-Network $0 copay for Diabetes self-monitoring training. $0 copay for Nutrition Therapy for Diabetes . $0 copay for Diabetes supplies.
21	Diagnostic Tests, X-Rays, and Lab Services	In-Network $10 copay for Medicare-covered lab services. $0 to $10 copay for Medicare-covered diagnostic procedures and tests. 20 % of the cost for Medicare-covered X-rays. 20 % of the cost for Medicare-covered diagnostic radiology services. 20 % of the cost for Medicare-covered therapeutic radiology services.
Preventive Services
22	Bone Mass Measurement	In-Network $0 copay for Medicare-covered bone mass measurement.
23	Colorectal Screening Exams	In-Network $0 copay for Medicare-covered colorectal screenings. $0 copay up to 1 additional screening(s) every year.
24	Immunizations	In-Network $0 copay for Flu and Pneumonia vaccines. No referral needed for Flu and pneumonia vaccines. $0 copay for Hepatitis B vaccine.
25	Mammograms (Annual Screening)	In-Network $0 copay for Medicare-covered screening mammograms.
26	Pap Smears and Pelvic Exams	In-Network $0 copay for Medicare-covered pap smears and pelvic exams $0 copay up to 1 additional pap smear(s) and pelvic exam(s) every year
27	Prostate Cancer Screening Exams	In-Network $0 copay for Medicare-covered prostate cancer screening.
28	End-Stage Renal Disease (ESRD)	General Authorization rules may apply. In-Network 20 % of the cost for renal dialysis $0 copay for Nutrition Therapy for End-Stage Renal Disease.
Additional Benefits
29	Prescription Drugs	Drugs Covered under Medicare Part B General Most drugs not covered. 20 % of the cost for Part B-covered chemotherapy drugs and other Part B-covered drugs. Drugs Covered under Medicare Part D General This plan does not offer prescription drug coverage.
30	Dental Services	In-Network $30 copay for Medicare-covered dental benefits. $0 copay for up to 1 oral exam(s) every six months $0 copay for up to 1 cleaning(s) every six months $0 copay for up to 1 fluoride treatment(s) every six months $0 copay for up to 1 dental x-ray visit(s)
31	Hearing Services	In-Network $30 copay for Medicare-covered diagnostic hearing exams $0 to $30 copay for up to 1 routine hearing test(s) every year $0 copay per hearing aid $1,000 limit for hearing aids every two years.
32	Vision Services	In-Network $0 copay for one pair of eyeglasses or contact lenses after cataract surgery. $30 copay for exams to diagnose and treat diseases and conditions of the eye. $0 copay for up to 1 routine eye exam(s) every year $0 copay for up to 1 pair(s) of glasses every two years $0 copay for contacts
33	Physical Exams	In-Network $0 copay for routine exams. Limited to 1 exam(s) every year. $0 copay for Medicare-covered benefits.
34	Health/Wellness Education	In-Network The plan covers the following health/wellness education benefits: Written health education materials, including Newsletters Nutritional benefit Nursing Hotline $0 copay for each Medicare-covered smoking cessation counseling session.
35	Transportation	In-Network This plan does not cover routine transportation.
36	Acupuncture	In-Network This plan does not cover Acupuncture.
37	Point of Service	Information Not Available
38	Estimated Annual Cost	$4,500
39	Provider Network	20000 and above physicians and providers. Click to View Provider and Physician Network Website
Important Notes
	Important Notes	Information Not Available
	Footnotes	¹Monthly Premiums and Estimated Annual Costs don't include any Medicare Part D (prescription drug) late enrollment penalty amounts that may apply to you. ²This is the Medicare Part B premium that most people will pay in 2010.

	Effective Dates	Effective Starting 01/01/2010 Effective Through 12/31/2010
Resources
	Benefits Summary	Click to Download
	Application Form	Click to Download

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HMO, PPO, PDP and PFFS plans with a Medicare contract available to anyone entitled to Part A or enrolled in Part B of Medicare through age or disability (for MA plans, individuals must have both Part A and Part B). Enrollment period restrictions apply; call the plan for details. Co-payment service area, and benefit limitations may apply. Medicare Advantage Plans are Health Plans with Medicare Contracts; Prescription Drug Plans are Medicare approved Part D sponsors. This website may display a subset of available plans based on your preferences and the plans Senior Educators contracts with.

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